대한대장항문학회

This clinical study is based on review of records of 87 patients with postoperative adhesive intestinal obstruction who were managed at the Department of Surgery of Dongbu City Hospital during 5 years from September, 1992 to August, 1997.<br>The results of study were as follows:<br>1) The most prevalent age group was 5th decade(44.8%) and male to female ratio was 1.7：1.<br>2) The previous operations were operation for appendicitis(32.2%), operations for peritonitis due to peptic ulcer perforation(24.1%), gynecologic operations(13.8%), operation for gastric malignancy(8.1%).<br>3) The mean value of duration between previous operations and postoperative adhsive intestinal obstruction was 36 months and the mean value of duration of symptoms was two days.<br>4) 42(49.2%) of 87 patients were admitted under 24 hours after onset of symptoms.<br>5) The chief complaints on admission were abdominal pain(98.8%), vomiting(81.6%), abdominal distension(78.2%), failure to flatus(55.2%).<br>6) 23 cases(45.1%) of 51 cases having one or more abnormal physical and laboratory finding(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis) were operated, and 5 cases(13.9%) of 36 cases having no physical finding were<br>operated (p value＜ 0.05).<br>7) Emergency operation was performed in 9 cases, elective operation was performed in 19 cases which had deteriorating clinical course despite of conservative management for 48 hours, and conservative treatement was performed in 59 cases.<br>8) The postoperative complications were observed in 6 cases and the most common complication was wound infection(14.3%).<br>In conclusions, The longer symptom duration and the longer interval between previous operation and onset of symptoms, the higer probability of surgical treatment is expected. The need for surgical treatment was increased acording the number of physical<br>and laboratory findings(fever, abdominal tenderness, abscence of defecation or gas out, or leukocytosis). For the cases which have unimproving and deteriorating clinical course despite of conservative management for 72 hours, surgical operation shoud be<br>considered.<br>